Web-Based Pharmacies: A Consumer PerspectiveThis is a featured page

Christye Y. Brown
Web-Based Pharmacies: A Consumer Perspective - PHI Wiki ProjectWeb-Based Pharmacies: A Consumer Perspective - PHI Wiki Project

As a result of reading the wiki entry on web-based pharmacies, the reader will be able to demonstrate the following learning objectives:
Discuss four major reasons consumers use of online pharmacies
List five benefits and risks of using online pharmacies
Discuss the general functions of VIPPS
Identify three warnings that will help determine a fake online pharmacy
List at least six "things to remember" if deciding to use an online pharmacy.

AN OVERVIEW
More and more consumers are using the Internet for health reasons. According to the market research firm Cyber Dialogue Inc., health concerns are the sixth most common reason people go online. For some people, buying prescription drugs online offers advantages compared to purchasing drugs from a local drugstore, including:

  • the privacy and convenience of ordering medications from their homes
  • greater availability of drugs for shut-in people or those who live far from the pharmacy
  • the ease of comparative shopping among many sites to find the best prices
  • greater convenience and variety of products
  • easier access to written product information and references to other sources than in traditional storefront pharmacies

Legitimate pharmacy sites on the Internet provide consumers with a convenient, private, way to obtain needed medications, sometimes at more affordable prices. The elderly and persons in remote areas can avoid the inconvenience of traveling to a store to purchase medications. Many reputable online pharmacies allow patients to consult with a licensed pharmacist from the privacy of their home. Moreover, online pharmacies can provide customers with written product information and references to other sources of information like the traditional storefront pharmacy.
While web-based drug shopping is known to save consumers money, in some instances this is not true. A survey in the fall of 1999 by Consumer Reports showed that buyers could save as much as 29 percent by obtaining certain drugs online. But another study, conducted in 1999 by the University of Pennsylvania and published in the Annals of Internal Medicine, tracked Internet sales of Viagra and Propecia and found that the two drugs were an average of 10 percent more expensive online than at local Philadelphia-area pharmacies.

GUIDELINES FOR ONLINE PRESCRIPTIONS
The American Medical Association adopted guidelines for doctors that specifically address online prescriptions at its annual meeting in June 1999. These voluntary principles recommend that doctors who prescribe over the Internet follow minimum standards of care. This includes examining a patient to determine the medical problem, discussing the risks and benefits of a drug with the patient, and following up to ensure the patient does not experience serious side effects. Many in the pharmaceutical industry back the AMA's action. "The relationship between physician and patient is critically important," says Martin Hirsch, public affairs director for Roche Laboratories Inc., maker of Xenical. "We support guidelines that will ensure that this relationship continues."

Unlike the traditional relationship between a patient and the patient's health care professional, some online practitioners issue prescriptions in the absence of a physical examination or direct medical supervision. According to the American Medical Association, a health care professional who offers a prescription for a patient the practitioner has never seen before and based solely on an online questionnaire generally has not met the appropriate medical standard of care. As a result, patients may receive a drug that is inappropriate for them to use and may sacrifice the opportunity for a correct diagnosis or the identification of an underlying medical condition for which use of the prescription drug may be dangerous.

PUBLIC EDUCATION CAMPAIGN
The FDA has launched a public education campaign to increase consumer awareness of the risks and benefits of buying prescription drugs online. The campaign uses several different approaches--including the FDA Web site, radio and print public service announcements, a newspaper article, a brochure, and outreach by public affairs specialists based in the FDA's field offices around the country--to broadcast the FDA's message. It is a violation of the Federal Food, Drug, and Cosmetic Act to dispense prescription drugs without a valid prescription. FDA will work with the states to determine the validity of online prescriptions and to bring enforcement actions under state law, federal law, or both, as appropriate. In addition, several state boards of medicine have ruled that such practice is medical misconduct and have fined and suspended the licenses of health care practitioners who have prescribed drugs in this manner.

Verified Internet Pharmacy Practice Sites
In late 1999, the National Association of Boards of Pharmacy (NABP) unveiled its Verified Internet Pharmacy Practice Sites (VIPPS) program, which provides consumers valuable information about the credentials of online pharmacies.
VIPPS is a voluntary certification program. The fairly rigid conditions the online pharmacy must agree to for acceptance into the program include:
  • maintaining all state licenses in good standing
  • allowing information about the pharmacy to be posted and maintained on the VIPPS Web site (www.nabp.net/vipps/intro.asp)
  • allowing an NABP-sanctioned team to inspect its operations, given reasonable notice
  • displaying and maintaining the VIPPS seal with a link to the VIPPS Web site.
VIPPS officials say the program is especially beneficial to seniors. "There is particular concern among the elderly population, which is often the target of unscrupulous marketing ploys," says Kevin Kinkade, NABP executive committee chairman. "VIPPS will be of tremendous benefit to consumers who need to be certain that the prescription medications they receive are from legitimate online pharmacies."

ORDERING PRESCRIPTIONS ONLINE
In general, legitimate online pharmacies operate this way:
  • Users open an account with the pharmacy, submitting credit and insurance information. The pharmacy is licensed to sell prescription drugs by the state in which it operates and in those states to which it sells, if an out-of-state license is required.
  • After establishing an account, users must submit a valid prescription. Doctors can call it in or in some states e-mail it, or users can deliver it to the pharmacy by fax or mail. The site then verifies each prescription before dispensing the medication. A written verification policy is usually posted on the site.
  • Some online pharmacies send products from a central spot, while others allow users to pick the prescription up at a local drugstore. Prescriptions usually are delivered within three days, often for no shipping charge. For an extra fee, many sites will deliver overnight.
  • Sites typically have a mechanism for users to ask questions of the pharmacist, either through e-mail or a toll-free number.
With hundreds of drug-dispensing Web sites in business, how can consumers tell which sites are legitimate ones, especially when it is very easy to set up a site that is very professional-looking and promises deep discounts or a minimum of hassles? "Consumers need to be cautious," says Jeffrey Shuren, M.D., medical officer in the FDA's Office of Policy, Planning and Legislation. "You should use the same kind of common sense you use when buying from any business. You look for a reputable dealer. You check the place out."

WARNINGS
Fake online pharmacies are scams that use the internet and spam emails to offer drugs and medicine at very cheap prices or without the need for a prescription from a doctor. These scams can cause both financial and health problems. Most spam email offers selling medicines or drugs are designed to steal your credit card details or to download damaging files onto your computer. Even if you actually do receive the products that you order, there is no guarantee that they are the real thing. In some cases, the medicines or other products may even damage your health. Remember that there are legitimate online pharmacies. These businesses will have their full contact details listed and will also require a valid prescription before they send out any medicine that requires one. If you receive an unsolicited email offering cheap or hard-to-get pills or treatments, watch for various signs that are probably indicators of fake online pharmacies:
  • The subject title of the email has nothing to do with the products offered.
  • The words in the email are spelled incorrectly or have apostrophes and spaces in the middle of the words (this is done to try to avoid anti-spam filters).
  • The email or website will sell you drugs that you would normally need a prescription for, even if you don’t have a prescription.
  • The pharmacy’s website is based overseas or does not include a contact telephone number or street address.
If you suspect a site is illegal, you can report it to the FDA by using the online reporting form on the agency's Web site.
___________________________________________________________________________________________

The FDA offers these tips to consumers who buy pharmacy products online:

  • Check with the National Association of Boards of Pharmacy to determine if the site is a licensed pharmacy in good standing (visit the Web site at www.nabp.net, or call 847-391-4406).
  • Don't buy from sites that offer to prescribe a prescription drug for the first time without a physical exam, sell a prescription drug without a prescription, or sell drugs not approved by the FDA.
  • Use sites that provide convenient access to a licensed pharmacist who can answer your questions.
  • Avoid sites that do not identify with whom you are dealing and do not provide a U.S. address and phone number to contact if there's a problem.
  • Be careful of sites that use impressive-sounding terminology to disguise a lack of good science or those that claim the government, the medical profession, or research scientists have conspired to suppress a product.
  • Talk to your health-care practitioner before using any medication for the first time.


REFERENCES
Australian Competition and Consumer Commission. Fake online pharmacies. Retrieved on November 27, 2007, http://www.scamwatch.gov.au/content/index.phtml/tag/FakeOnlinePharmacies

Eustice, C., & Eustice R. (2006). Safe Or Sorry - 10 Tips For Using An Online Pharmacy. Retrieved on November 10, 2007, http://arthritis.about.com/cs/onlinepharm/a/onphsafeorsorry.htm/

Frederick, J. (1999). NABP launches Internet review as Congress eyes online pharmacy - Brief Article. Drug Store News. Retrieved on November 22, 2007, http://findarticles.com/p/articles/mi_m3374/is_14_21/ai_55821160

Henkel, J. (2000). Buying Medicines and Medical Products Online FAQs. FDA Consumer Magazine. January-February 2000. Retrieved on November 10, 2007, from http://www.fda.gov/oc/buyonline/faqs.html/

Henkel, J. (2001). Buying Drugs Online--It's Convenient and Private, but Beware of 'Rogue Sites.' Retrieved on November 27, 2007, http://www.fda.gov/fdac/features/2000/100_online.html


RELATED EXTERNAL LINKS

http://www.pharmacychecker.com/sealprogram/choose.asp - PharmacyChecker.com Verification Program

http://www.fda.gov/oc/buyonline/faqs.html - Frequently Asked Questions: Buying Drugs Online

http://en.wikipedia.org/wiki/Online_pharmacy - Online Pharmacy

http://www.scamwatch.gov.au/content/index.phtml/tag/FakeOnlinePharmacies - Fake Online Pharmacies



natkinson
natkinson
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natkinson Getting the word out 0 Dec 13 2007, 8:16 AM EST by natkinson
Thread started: Dec 13 2007, 8:16 AM EST  Watch
I hope that the public, particularly seniors, know how to check the credentials of e-pharmacies! They may be more willing to overlook questionable practices to get some cheaper medications online. I wonder if Canada and Mexico have some similar guidelines for e-pharmacies that Americans can view.
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sassy02 I use this 0 Dec 11 2007, 2:56 PM EST by sassy02
Thread started: Dec 11 2007, 2:56 PM EST  Watch
I love internet pharmacies! I love the convenience of not having to make two trips to the store. Of course there are still those times when you have to go to CVS for other essentials so waiting is not a problem. But during those other times it's great to just pick it up later. I have never had a problem with them losing a prescription and I think if people can get over the security issues, this will be a great thing for less mobile populations. The next step is a mobile pharmacy!
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